Happy Gambian Birthday!

This Saturday it was my 29^th Birthday out here in The Gambia… and I was determined to have a fun, relaxed, happy one…. I succeeded!! 

I woke up to bright blue, cloudless skies… no surprise there…. spent the morning opening the cards and presents that had made it here on time and made myself pancakes for breakfast before heading down to coco ocean for a full body massage!  Mum had sent me some money to treat myself so I did just that!

Breakfast!

 

After a relaxing hour or so in the spa, which was definitely worth every butut, I set out in the sun with my book until I was joined by my friends early afternoon to continue the celebrations!

Sushi and wine for lunch was followed up with champagne and relaxation, swimming, sunning and chatting until it was time for sunset, when we headed down to the beach for cocktails!

I had a fabulous day and the evening was very similar, filled with friends, food, drinks and good times!

Just a short blog for today but there’s only so much I can say about lying in the sun with a drink in my hand 🙂

Tara and I

 

Nic and Nathalie

 

Thank you to all my wonderful friends and family, both in The Gambia, back in the UK and elsewhere in the world for the lovely messages! Love you all!! xxxx

Emotions…

Even this far into my journey here with VSO, over halfway through, the continuing mix of emotions astounds me… when I try and put into words all I have felt this week alone it leaves my head spinning, but I thought I’d try and write it all down…

Happy and settled…. at the weekend, coming back to Gambia after the Dakar weekend and spending 2 days on the beach with good friends, eating fruit salad and soaking up the sunshine (We had Monday and Tuesday as public holidays as it was the 48^th anniversary of The Gambia’s independence on Monday)

Sad as I see more and more people leaving to go home…. Bea and Ed came back after their 2 week holiday in Togo and there was just enough time for a drink at Leybato and a meal at ‘The Wonderful Chinese restaurant’ before they flew back to the UK on Wednesday…  Also even sadder is that some of the group who arrived at the same time as me are starting to leave now too… Jasmine left last week after 3 months here and Graeme followed her to Amsterdam shortly after, this Tuesday as he had completed his 5 months teaching architecture at the Uni.  For both we had a night at Asorock so they could have their favourite dish of tomato stew before they left.  Patrick from our VSO intake also left this week, ending his proposed 2 year placement at just 5 months as he had been feeling frustrated for a while now that he wasn’t achieving what he wanted to here.  It feels strange to start seeing our own intake go as previously it had been people who had already been here 1-2years that we didn’t know as well!

Excited for my younger sister Jennifer, who got engaged to her boyfriend, Kyle, a couple of weekends ago and has been sending me pictures of dresses!  And also for Natalie and Williams, who got engaged just this past weekend…. The fairytale romance of our group :-)… Congratulations!!

Suddenly panicked when I realised on Tuesday evening that in 5 months time I will be back at home in a rainy British summer… back to work…back to real life… and missing my new friends the white sand beaches that I’ve grown to used to frequenting every weekend!

Then in equal measure….

Irritated by the bumsters calling out to me as I walk by, the children asking ‘give me football/ minty (sweets)/ money/ bread, the taxi drivers hissing or beeping their horns and the many calls of ‘Toubaab, Toubaab’.

Frustrated as I try and reason with the Cuban consultant and Gambian junior doctors about the management of an unconscious patient with severe diabetic ketoacidosis, who had already been given only saline, and no insulin, by the peripheral health centre he was kept at for 24hours.  As I try and argue that although he is extremely dehydrated and his blood sugar is too high to read on the monitor we should rehydrate him slowly so to avoid giving him cerebral oedema (swelling on the brain) I start to feel like a broken record… cerebral oedema, cerebral oedema, CEREBRAL OEDEMA!!! Argh!  Even with a textbook and a journal article in front of them that says the exact same thing I am… everyone comes to the conclusion that he should get 6 times the amount of fluid per hour that I have calculated… in order to get him better quickly! Sometimes I wonder why I bother….. but instead of walking away (even though I was seething!) I sat next to the boy for 4 hours today, ensuring they didn’t speed the fluids up while I wasn’t looking, and doing his hourly observations, blood sugar level and insulin injection myself.  Here comes my next emotion… Apprehension and anxiety as I left for the day, wondering how this boy’s management will go overnight whilst I’m not there!

Angry… that I am constantly having to argue with everyone at work

Guilty… that I don’t stay long enough/ do enough for each patient/ do any on-calls

But also aware that I’m trying to make sustainable change here in true VSO style and if I do everything for them then nobody will learn….

This week I have also felt in awe of the children here, who are often so sick and in so much pain, but they just get on with it… much more than the British stiff upper lip!  It makes it difficult to tell if a child is in pain when you feel their abdomen, but when you take blood or insert an IV cannula even a 5 year old will sit still patiently and let you get on with it.. unlike the kids at home who kick and scream and pull away, even with the use of local anaesthetic cream, gas and air and sometimes even midazolam!  I even watched a 12 year old girl have a needle inserted into her chest to drain fluid off from around her heart, as she had a 5cm pericardial effusion, without any anaesthetic yesterday (at home this would be done under ultrasound guidance and a general anaesthetic).. granted, she screamed a little, but so would I  have… and I felt like crying I was so terrified for her (yet another emotion!)

On and off I still feel homesick.. mainly when the last few emotions get the better of me, when I’m tired and grumpy and dehydrated, frustrated with the world and how unfair the balance of things are… it makes me look forward to coming home in July, restarting work in August and everything making sense again!  But then I realise this is my once in a lifetime experience (for now anyway!) and I take a deep breath, count to 10, make a cup of tea, put some music on, read my book, head to the beach… anything to make myself feel better and try and sit back and enjoy the ride!

A Trip to The Big City!

After much anticipation, but some fairly last minute planning (compared to my usual anyway) Tara and I set out on Friday morning on our trip to Dakar for the second road trip of this month!  As this Monday is The Gambia’s independence day we had opted for the cheapest option of travelling overland for the ~300K journey and had been given instructions by other VSO and Peace Corps volunteers on exactly how to travel there on the public transport.

Ready to go!

 

The journey there was an adventure in itself… we caught a taxi to Banjul, then a small boat, called a Pirogue across the river Gambia, another taxi, then, after walking across the border between The Gambia and Senegal a motorbike taxi to the waiting sept plas taxis (7 seater cars) that would take us the rest of the way to Dakar.  There are 2 ways of crossing the River Gambia from Banjul to Barra, the first is the main ferry, which can take both foot passengers and cars and is the cheapest option at 10dalasis, but there are often long queues and delays if the current of the water is flowing in the opposite direction or the engines fail (a frequent occurrence!) Tara had crossed on the Pirogues when she went up-country a few weeks ago so we decided to brave that option.  The Pirogues are small wooden boats sat in the shallows of the river, to board them you have to climb up onto someone’s shoulders who then carries you to the boat and you climb aboard from there… no mean feat carrying our luggage and handbags, I had a scraped knee and very shaky legs by the time we sat down to watch the water pouring in through the cracks in the side of the boat and wait for it to fill up before departure!  Before it left to make the crossing 2 boys had to bail out the water whilst someone else passed around lifejackets (received gratefully!) and another collected the fare of 15dalasis.  The crossing itself took a mere 20min and before I knew it I was climbing onto another person’s shoulders once again, with my feet dangling in the water, being carried ashore to jump in another taxi!

On the Pirogue….

Sitting in the Sept-plas, listening to my ipod, watching the Senegalese countryside pass by the window I felt ridiculously content and excited about seeing another part of Africa and pleased to be out of The Gambia for the weekend…. that was for the first hour anyway… 200k of potholes, unmade roads and swerving to avoid goats later I was patting myself on the back for remembering to take my travel sickness tablets that morning and feeling rather windswept from sitting next to the open window for the entire journey.

Almost 11 hours after I left my little house in Fajara that morning we pulled up into the city… and a city it is!  Tara and I stared open-mouthed at the tall buildings, the traffic, the motorway with road markings and signs and the bright lights… we couldn’t believe we were still in Africa!  As we were feeling a little jaded from the journey, Friday night we just checked into the hotel, showered and ate (an amazing burger from a place across from the hotel) and headed to bed so we could wake up and start the next day fresh.

The next morning, we set out into downtown Dakar, armed with the lonely planet, ready to do some sight-seeing!!  First stop, by popular demand, was the Senegal airlines office to book a flight home…. spoilt children as we are, we had decided that one experience of the overland journey was enough and we’d fly back, thank you very much!! Haha!  Once we had booked the flight successfully and had a little wonder round the city streets we headed to the Institute de Francais to look round the grounds and stop in Le Bideew cafe for lunch.  Both Tara and I have been craving nice salads for a while so the menu here of fresh, healthy food was like heaven and we both chose without difficulty. 

Healthy eating in Le Bideew Cafe, Institute de Francais

 

After lunch we headed over to the Ile De Goree, a short 30min ferry ride off the coast of Dakar, the island was where the slaves used to be held before being shipped away and is now a haven of museums, gorgeous colonial buildings and small restaurants.  We wandered round taking photos and marvelling at the different buildings and structures, having Tara with me made me really appreciate it as she was so enthusiastic about the different aspects of the architecture.  The island felt very Mediterranean, with brightly coloured buildings, narrow alleyways and the sun streaming through trees.  We had a short foray in the tourist market, where we both made some nice purchases after bargaining harder than the traders there expected (we upset a few people, but got our own way in the end!) then we sat looking over the beach and jetty drinking coffee and eating crepes au chocolat while we waited for our ferry back to the mainland!

Buying fruit on Ile De Goree

Tara walking the street of Goree

Looking back at the Dakar Skyline

 

Saturday night we had been invited to a party being held by the Peace corps, who were all gathered in Dakar for a west Africa international baseball tournament called Waste.  We were quite tired after a long day sight-seeing but decided to pop in to say hi and grab a beer on our way back to the hotel.  We pulled up in the taxi at the venue of the party and felt like we were in another country completely…. we were at a large bowling alley at a mall, with bright lights and pumping music… and about 100 American Peace Corps volunteers…. talk about culture shock, it felt like I’d closed my eyes and opened them in the US!  Even after our day in the city the contrast made both mine and Tara’s head spin so after just one beer we made our excuses and left for the hotel!

In the bowling Alley…bit confused as to which country we’re in!!

 

After our busy day in downtown Dakar on Saturday we headed north to Ngor for the day on Sunday.  First stop was the Village des arts, a Village where about 20 artists have workshops and you can wander round the gardens where their work is displayed.  It was very peaceful to walk around, dipping in and out of the building, watching the artists at work and admiring the pieces.  I’m no art connoisseur but I could tell there were some brilliant pieces there, and if I hadn’t been worried about getting it back to The Gambia in one piece I would have bought at least one item!  After our stroll round the village we spent the afternoon relaxing with a coke on Ngor beach, looking out at the Ile de Ngor, a small island popular with surfers, and reading our books.  Although we spend a lot of time on the beach in The Gambia, this was a totally different experience, packed with parasols, deck chairs and tourists… it made us homesick for our beautiful stretches of deserted white sand beach that we have got so accustomed to!

The Garden at The Village Des Arts

 

 

Afternoon relaxing!

 

We had one more stop before it was time to check in at the airport for our 11pm flight home… and that was tapas and sunset drinks at a gorgeous restaurant in Des Almadies called Restaurant Le Ngor.  One we picked out in the lonely planet, the building is adorned with seashells and bright colours, and again felt very Mediterranean… a feeling made stronger by the meal of tapas we enjoyed whilst watching a vibrant sunset!  As we sipped our beer and ate our meal of calamari, tempura vegetables and beef in tomato sauce peahens flew onto the bamboo roof above our heads, a peacock roamed the beach and some storks were sleeping just outside the entrance… a great way to end our Dakar weekend!

Beautiful Senegalese sunset!

 

So after we spent a gruelling 10 hours travelling overland to Dakar from Banjul, we flew a mere 30 minutes back!!  10 times the price of the journey for 20 times less the time… totally worth it!!!  All in all an amazing weekend, a taste of city life, a bit of culture shock, a chance to practice speaking French, some good sightseeing, delicious food and beer that wasn’t Julbrew!  What a great way to mark my halfway point of my placement here with VSO.  It’s amazing that just 2 days away from The Gambia has made me miss it and reinforced how much I love the country… even with the stresses and annoyances, I missed the friendliness of the locals, the long stretches of beach, the quietness…. It was nice to feel the vibrancy of a city again but I felt relieved to arrive back and am excited to walk down to Leybato and have a relaxed beach day today!

‘This is The Gambia….!’

Whenever anything happens that is typical of The Gambia, whether it is a minor inconvenience or annoyance, something disastrous or even just something amusing we have taken to shrugging our shoulders and saying ‘TITG’ or ‘This is The Gambia’!  Often this is after a bit of a rant to each other about said event and alongside a Julbrew or 2!

The past week or so, despite the fun weekend in Kartong has been a bit of a TITG week for a couple of my friends and as always with our close knit group that is our family whilst we are all so far away from home we all feel each other’s pain as if it was our own.

The morning before we set of for Kartong Tara was crossing the main road when someone on a motorcycle came from behind a car letting her pass and careered into her, sending her flying to the floor.  They then muttered a Gambian ‘sorry sorry’ and sped off again, leaving poor Tara luckily only bruised physically, but pretty shaken up.  One of our worst nightmares here are accidents like this as the health care system is so bad, with no ambulances to come and pick you up if you are hurt and need medical attention, we would be relying on public transport or friends with cars (few and far between) to get us to the nearest health centre, where the facilities for injury aren’t great anyway!  We were all relieved that, although shaken, Tara was in one piece and we managed to enjoy the weekend anyway!

Arriving back from the weekend however, Nicola found that her little house in Kanifing had been broken into and all her electronics stolen- laptop, hard-drive, MP3 player, speakers… absolute disaster and the rest of us were all shocked and angry when we heard, and of course we have been worried since then how safe the area that she’s living in is!  A neighbour who Nic has made friends with since our arrival came to talk to her about it the afternoon we got back and assured her that he knew all the thieves in the area and so would go round to all of them and see if he could find her stuff!  Later that evening there was a knock on the door with the 3 thieves bringing her belongings back, which was good, but still such a shocking experience.. especially when they said that she should ‘show some gratitude’ and not go to the police as they had brought the stuff back, they also suggested maybe they could come round and hang out sometime… needless to say the answer was no to that one!  The next day the police phoned whilst we were in our 3 month review at the VSO office to say they had caught the thieves and had them in the station… word must have got to them somehow as Nic hadn’t got round to telling them who it was!  I went down to the station with her in the VSO car with a couple of the office staff for moral support and to show them the stuff that had been stolen… as with all procedures in The Gambia it was a bit of a farce, with them first of all just all staring blankly at us as the story was re-told (despite the fact they had called her to come in!)  then the request that they keep her laptop etc for evidence until the case went to court… Luckily as Nic needs the laptop for work she managed to keep her stuff and just get them to write a statement!

As always when these things happen it makes you feel a million miles away from home and this week wouldn’t be the first time (or the last) when at least one of our group is saying…’I just want to go home!’  But we power on through and support each other.  Tara is recovered and Nic has her belongings back and is hopefully moving house to a more secure compound and area… however both have been feeling unwell this week too which makes it 100% times worse!!

Despite these events we managed a few treats for Nic’s birthday on Monday.  We ordered a cake from La Parisienne to be delivered to the VSO office where we all were and a nice meal out at a place called LA live in the evening!  Shrove Tuesday called for a gathering in my house to gorge ourselves on pancakes with lemon and sugar, maple syrup, bacon, sausages, pineapple and cheese (I made so much mixture that I’ve had pancakes for breakfast the last 2 days too!) and last night we all gathered as Asorock for Jasmine’s last night so she could have her last taste of Nigerian tomato stew with Fufu.. her favourite dish here! Hopefully our group has had its fill of bad fortune for now and we can enjoy some stress free times ahead, I’m sure there will be many TITG moments but hopefully they will stick to minor ones from now on!

What Goes On In Kartong….

After a very successful first week in the OPD and after what felt like weeks of looking forward to it this weekend was the Kartong Festival.  Nic, Nat, Tara, Graeme, Jasmine, Abdou and I hopped into cars organised by Dodou on Friday afternoon to head down to the village of Kartong and Boboi Beach Lodge, where we are staying for the 2 nights.

All gathered ready to set off

 

As always in The Gambia there were some hiccups in the journey when Dodou’s car overheated about halfway there, but eventually we got there, settled into our room and tent (Nic brought her tent from the UK and it was cheaper to camp!) and hit the beach.

Uh..Oh….

 

Our Roundhut accomodation!

 

Our days were spent lazing on the beautiful stretch of beach that Boboi is situated on and both Friday and Saturday evening we headed down to the festival with was held in a local school grounds.

Nic and Nat riding some waves!!

 

Being there with our Gambian friends we managed to avoid the ‘Toubaab’ entry price of 100D and purchase tickets through clandestine holes in the school wall for just 25D per person!  Once inside we were hit with the sounds of local drummers, the smell of food from the street sellers lining the perimeter and the view of the dancers in their brightly coloured clothes!  Of course we headed straight to the stall selling the Julbrew! The crowd was filled with locals of all ages and plenty of travelling visitors, we even made friends with a couple of guys who were here on Holiday – Mickey from Germany and James from South Africa.

Tara at the ‘hole in the wall’!!

 

Our view of the action

 

After 5 months here in Gambia and having spent all that time in the Kombos I had been looking forward to this weekend away for-absolutely-ever, and it definitely didn’t disappoint!  However I can’t really go into much more detail about the goings on of the weekend further than that as what goes on in Kartong, stays in Kartong!! Haha!

The week ahead is destined to be a very busy one so not much time to recover from the weekend’s festivities… Today is our 3 month review workshop in the VSO office (although we have been here for 5 months this week – Gambian time!) and also Nicola’s birthday – happy birthday Nic! We have decided to have a get together on both Tuesday for pancakes and Wednesday as it’s Jasmine’s last day here before she heads to Holland to visit her sister… then at the weekend Tara and I are planning another road trip to Dakar in Senegal… something else I am pretty excited for!  Plenty of material for next week’s blogpost!!

If You Can’t Beat Them, Join Them!

With each month here that passes I feel more and more settled, so much so that it feels like a lifetime ago that I was feeling so stressed and miserable last November when I came home for that week.  I know that in a few months when I start getting ready to move home, although I’m sure I’ll be ready for it, it will definitely be bittersweet!

This week there have been a number of things that have occurred to me that show how settled here I am and how much I feel at home:-

1. It feels normal to wake up under a mosquito net each morning
2. I’ve stopped taking photos of ‘normal’ things like goats by the side of the road!
3. I walk right past stray dogs barking at me without even sparing a thought to ‘what if they bite me and I catch rabies’ (scared me a lot in the beginning!)
4. 100 Dalasi (£2) feels like a lot to spend on lunch!
5. I crave rice if I haven’t had for a few days!
6. Last weekend I baked cakes – first time since I’ve been here and a normal weekend activity for me at home!
7. I don’t spend every spare moment of my time at the beach anymore (life has got too busy!)
8. I have put 14 of the 17lbs I lost in weight before Christmas back on again (dammit!)
9. I feel cold when the temp has dropped to 21 degrees!
10. I’ve stopped carrying the ‘essentials’ of water, mosquito repellent and suncream in my bag wherever I go… although I should really start again as I got ravaged by Mozzies this week and its starting to get hotter again!

However, I’m still well aware I’m in Africa when every guy I pass in the street, even from 100m away, shouts hello or hisses at me to get my attention and it still annoys me!  One guy cycled along next to me on Wednesday night telling all about how he thinks he needs a white girlfriend now because his last girl was pregnant by him, had the baby, who died shortly after birth but she didn’t tell him any of it and then when he went to her house he found out she had 3 other children.  And of course a white girl wouldn’t do anything like this….’so, how will I see you again!’  This was in pitch black and I’m pretty sure all he could see about me was my white skin… I tried to tell him I’m sure colour doesn’t matter in these situations and that white girls can do things like this just as much as black ones!  Then I said I’m terribly sorry but I do have a husband back in England… I have told so many stories about this husband I have in England that I’m really looking forward to getting back and meeting him… starting to believe it myself!! 🙂

This week was my first week working in the Paediatric outpatient department (OPD).  Dry season in Gambia – November ’til July is the quieter season with the summer months in rainy season being busier, so it’s been quite nice and calm and is giving me a chance to settle into my new role.

Each morning this week, after handover, I have sat with the juniors and had a cup of coffee and shared breakfast with them, something I never did when I was on neonatal as I was always aware that we had a ward round of 30 patients to get through.  The result of this is that I feel a bit more accepted within the juniors and that I’m building up a better rapport with them.  I have headed along to the OPD late morning, armed with my WHO pocketbook of child health for developing countries ready to see some patients.

The OPD sees a mixture of emergency cases who turn up directly, those who are referred from a peripheral health centre (who are usually fairly sick as the health centres tend to refer anyone who is worsening under their care), follow ups from previous attendances and minor illnesses.  My first week has been filled with a mix of bread and butter illnesses that I deal with all the time in the UK such as gastroenteritis (a LOT of gastroenteritis – I have been handwashing a lot as paranoid I’ll catch it!), coughs and colds and bronchiolitis, as well as the weird and wonderful tropical illnesses, some serious cases who present late with meningitis and some just very vague complaints (all over body weakness for past 2 years – in a 14yr old!)

I learnt that vomiting up worms is indicative of a particular worm infection – ascaris, how to deal with severe malnutrition and how to organise for a patient to get tested for HIV infection.  I truly have learnt something new everyday this week!

However, although so far I am enjoying my foray into developing country paediatrics so far it is not without its frustrations, which are very similar to the frustrations I felt on neonatal!  We don’t have an otoscope or tongue depressors, essential equipment for paediatrics usually as many children with fever will have tonsillitis or an ear infection, which without these things we can’t check for; parents are fairly unmotivated when feeding/rehydrating their children and with 2 patients this week I have sat and given oral rehydration solution in small amounts every 5 mins myself as the mum’s were sat staring into space; things seem disorganised at times, It’s difficult to tell which patients are waiting to be seen and the reliance is on Ida, the head nurse to tell me who to see and when (although slightly more organised than neonatal in that respect).

My other frustration, and one that’s not going to change anytime soon, is that of the Cuban doctors!  My experience this week has been that very odd and conflicting advice is given to the juniors in management of patients and there are 2 examples that I already have of this…

1. We had 2 patients aged approx 1 year with bronchiolitis on the same day, the first was very mild, feeding well, didn’t need oxygen, but The cuban wanted to nebulise and admit for IV antibiotics, neither of which work in bronchiolitis… I would have sent the child home with advice but I was overruled.  The other child was extremely wheezy and had severe respiratory distress so I wanted to nebulise them and I was told ‘no, you can’t nebulise as they are tachycardic’ ( have fast heart rate – nebulised salbutamol has the side effect of making them tachycardic)  I responded with – ‘of course they’re tachycardic, they can’t breath’ a short discussion followed then I got the nebuliser myself and stood over the patient to ensure they got a full 3 back to back nebs to help their breathing!  All the while thinking, I’m pretty sure we treat people in an A-B –C fashion universally! (airway, breathing then circulation!)  I’m pleased to say the child improved after nebulising and 2 days later is much improved on the ward!

2.     We had a 14yr old girl in with focal neurological signs and abnormal gait, with a history of dizziness, headache and vomiting and a reported feeling feverish but no documented fever.  Both the house officer and myself had an odd feeling about this girl and decided to cover for meningitis but not to perform a lumbar puncture until after we had got a CT scan of her head as we were worried that she could have a tumour or something causing her symptoms and we didn’t want to risk her coning (her brain being pushed down through the opening to the spinal canal).  The consultant tried to insist that we did an LP, but we refused and sent her to the ward.  Unfortunately a CT wasn’t possible straight away.  The next day in handover we learnt that she had coned overnight very suddenly and passed away… I was shocked but very glad I trusted my instincts and the house officer’s otherwise if we had LP’d her we would’ve had a very unpleasant experience!  It was a shame we never had a CT so don’t know the exact cause of her demise.

Talking to Dr Okomo about it yesterday I’m aware that the head of department is well aware of the difficulties and that they are doing their best to combat it by teaching the juniors the correct way of doing things but it is proving difficult.  So far I have been very impressed with the 2 house officers working in OPD with me as they take the difficulties in their stride and generally know when to follow the advice and when not too, but I feel sorry for them that they have to take that responsibility on themselves!  And to top it off, with me there, although I know what I’m doing with the conditions I see in the UK, they now have me asking them for advice on things like malnutrition and worm infections as well as helping me with translation when the nurses are busy!!

I’m sure I’ll catch on quickly though, and I can already see areas I’d like to help them improve in my couple of months in OPD!

A Chillaxed Weekend, end of Neonates and a hospital visit!

The past weekend was spent absolutely perfectly! Nat, Nic and I hadn’t seen each other all week due to Nat being up-country completing the VSO annual partnership reviews with Ebou and Ba Sarjo from the office and Nicola unfortunately being out of contact as her phone was stolen at a local club the weekend before.  So we decided to meet at midday on Saturday to try out a cafe we had heard was good for coffee.  We made it down to Caramel for about half past and chilled out in the shade drinking cappuccinos, eating Lebanese Foules and Cream cheese followed by big slabs of cake and more coffee!  We were having such a good time, deep in conversation, that we hardly noticed what a bill we were racking up….. luckily between the 3 of us we had just about enough cash to cover it! We would have been washing dishes otherwise!!

Mmmmm… coffee and cake!

 

After that we had a quick visit to the craft market (or as quick as any trip to the market in Gambia can be!).  I needed to see the brother of a leather stitcher as when Ellie and Vicki were here we had ordered loads and unfortunately Ebou, the leather stitcher, passed away a couple of weeks ago before he had time to fulfil the order.  His brother looked very sad and I felt terrible coming to sort the business out, especially as he looked so stressed when I said I’d already paid the 3,350dalasis (about £60)… as I assume the money has already been spent by Ebou!  But the good news is someone else in the family is also a leather stitcher so the bags will be made at some point.

We took another long walk back to Fajara along the beach in the sunshine, a drink at Leybato then topped the day off with bacon sandwiches, a bottle of red wine and a film at my house… felt like a perfect Saturday!

Sunday I had lots of plans, I wanted to take an existing bag of mine to Ebou’s brother so he could copy it for the order, Bea and Ed were dropping stuff at mine they no longer needed for future volunteers and then their leaving do was at 2pm… a hog roast that I was mega excited about!  Unfortunately I didn’t get a chance to do any of this as when I tried to let myself out my house in the morning the lock on my front door broke! I managed to get out the house but then couldn’t shut or lock the door after!  I phoned the VSO emergency phone (and woke Haddy up!) but unfortunately the carpenter couldn’t come until the evening…. so I was on house arrest for the day!  Luckily for me Nic, Nat and Tara decided to come keep me company, and then we were joined by Alieu and Rohey… who had put on their party clothes, I think they thought I was having a party like before Christmas with so many people there!

Chilling with Alieu

 

Terrorising Tara!

 

I was sad to not get a proper chance to see Bea and Ed off, but they have headed to Ghana for a 3 week holiday and will be back here before eventually going back to the UK so hopefully chance for beers and tears then!

Today was my last day on the neonatal unit and was a very calm one, My little Mariam (see previous post) has gained 100g over the weekend and now weighs 1.2kg, she is starting to breastfeed directly and I hope will be going home at the end of the week when she reaches 1.3kg (and before she catches an infection!).  A fair few other babies were discharged today also and it felt a bit like the end of an era!  I’m looking forward to heading down to the paediatric OPD/Emergency room tomorrow and starting out again by just observing how things work down there!  Planning on a spot of revision of WHO guidelines for developing countries this eve!

With my Neonatal team! Kalipha (house officer), Ceesay (medical officer), me and Mariama (medical officer)

 

I also headed down to Africmed today, the private health facility that us volunteers go to if we are unwell, not for myself but because another volunteer, Pompey, who is based up in Basse, was admitted last week.  He was brought down from Basse as he had a pneumonia and pleural effusion and admitted here for treatment.  I have been feeling bad all week as I hadn’t had a chance to go see him yet, and I know it feels horrible being unwell when you are so far from home, let alone being admitted to hospital and taken away from the place you call home here in The Gambia.  So after work I hopped in a taxi and after stopping for some meat pies, biscuits and bananas to take for him I arrived at Africmed health centre. 

Pompey was on a small bed in the observation area in the main clinic, having not made it onto the main ward despite being there for almost a full week!  He had had a chest drain inserted over the weekend to drain the effusion and was feeling pretty ropey and miserable.  Having said that he brightened up when he saw me and said he felt better for just having a visitor (making me feel even guiltier for not having been earlier!).  While I was there, Mr Solanke, the Indian Surgeon from RVTH (who operated on my congenital diaphragmatic hernia baby) turned up to remove the chest drain and we had a bit of a chat about Pompey’s condition (me pretending I understood adult medicine – I’m sure adults are just big kids right?!?).  Turns out VSO are planning on flying Pompey home to rest before he goes back to Basse to continue his placement, I don’t blame them, but he can’t fly quite yet as the chest drain has only just been removed and there would be a risk of pneumothorax (air in between the lung and chest wall – can be fatal on a plane!) if he flies too soon!  Plenty of time for me to make up for not visiting last week!  Pompey is the 3^rd one of our September intake of volunteers to end up admitted for one thing or another and it’s reminded me how important it is for us to look after ourselves, and each other!

4 Months in….

So here we are, February, wow! I can’t believe it’s been 6 months since I was living and working in Liverpool! I’ve been in The Gambia for 4 ½ months now and have just come to the end of 4 months working on the neonatal unit in RVTH, it’s been a pretty typical week, actually quite a pleasant one, despite the usual ups and downs and feeling a little fed up with the whole VSO malarkey at the beginning of the week!

Work has been pretty standard, much like my day I described on Monday, but the past 2 weeks we have had a group of 3rd year medical students from the postgraduate course at Swansea Medical School here on a link project that they have with the medical school here. We had a group here at the end of last year also, but I feel like I’ve had more time to spend with this group. It’s been really nice to have some new faces around and I enjoyed showing them around the unit and getting to know them at a couple of meals out. I felt a bit bad when we had quite a traumatic morning on Wed when Kate, one of them, spent the morning with me, with 2 babies dying on us within the first hour… but I guess I can’t really control that!

The rest of the week at work was uneventful thankfully, I even had time today to sit and chat with the 2 medical officers I work with and get to know them a bit more. Ceesay is a few years older than me and has a real desire to learn anything I have to say about neonates (he even said he thought I was a neonatologist!! Haha!! Yeah right!) and Mariama has just completed a masters in child health in Perth, Australia so we had a lot of stories to compare about living in a culture that is different from your own. I feel like I built up a really good rapport and built on the relationship we already have today, we even talked a little about the paeds department and what they found difficult. I feel like I have turned a corner in my relationship with the other junior doctors just today, and feel a little more accepted, which made me feel more comfortable and happy!
The only downside at work this week was that I decided to do some quick calculations on the mortality rate for January… things have felt calmer and subjectively it felt like there had been less mortalities to deal with. I was right on the calmer front, we had only 105 admissions compared to the usual 175ish but the mortality rate is still up at 40%…. so much for improvement!

Outside of work I’ve been pretty busy too! Tuesday was Nathalie’s birthday and as I couldn’t make her birthday meal on Wednesday eve I treated her to a cocktail and desert at Gaya, which we decided to have instead of dinner, it was so nice to sit in pretty much luxurious surroundings enjoying a peach marnier cocktail with a pear crumble and ice cream!!

The VSO regional director for Africa, Sam, and the head of funding for Africa, Stephanie, were in country this week to see how things were going and they had invited a handful of volunteers out for dinner on Wednesday for an informal meeting. I was lucky enough to be invited and so enjoyed an extremely nice meal of fillet steak, with a glass of wine followed up with cappuccino… a rare treat! The meal was fun and we got on really well with Stephanie and Sam, who not very subtly brought in topics of interest to them with well placed questions… such as ‘so, how is life as a volunteer in Gambia?’, ‘do you find you can survive on the volunteer allowance?’, ‘Would you mind if we asked you for money and fundraising once you have finished your placement’, ‘how do you think VSO The Gambia could improve’ etc etc!! A few controversial issues came out during conversation, including a spot of gossip about other volunteers! At the end of the meal Sam thanked us all for our contribution to the developing world and raised a toast to us, saying that VSO would be nothing without the volunteers! It made me feel very proud to be part of this, and along with my progress with my relationship with the junior doctors this week (and a couple of hours in my happy place on fajara beach today!) has left me feeling very happy at the end of this week, with no regrets about what I am doing, and it has reminded me to savour every moment… even the hard ones! Nobody ever said that the good experiences were always the easy ones… and certainly nobody ever said doing VSO would be easy!

So 4 ½ months in, pretty much halfway through and this girl has a smile on her face… and taking things one experience at a time!!